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Family Christian Academy
Program
Enrollment Date

MonthDayYear
Date
IMPORTANT:

Please carefully select the correct school year for enrollment.

Do not select a previous year unless you are paying a past-due enrollment fee.
26/2725/2624/2523/24

New Enrollment (Never been enrolled)Re-Enrollment (Enrolled last year)Returning Student (Previously enrolled with FCA, transferred out and now returning)
Student Name*

First NameMiddle NameLast Name
MaleFemale
Grade*
Student D.O.B*
MM/DD/YYYY
SSN*
555-55-5555
Address*

Address

Street Address Line 2

CityState

Zip
County*
County.*
(Not country)

You must provide a valid school fax number or email address to request records. Please contact your previous school and ask for the best fax and/or email for records requests. Records will not be requested without this information.
Previous School Attended*
Not Applicable
Previous School Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Previous School Phone*
Previous School Fax
Previous School Email*
example@example.com

IMPORTANT:
Submission of this enrollment form acknowledges that...
You have read and agreed to Family Christian Academy's Policies.
You understand that submitting any false information will result in the immediate nullification of this enrollment.

FCA does not provide refunds for services.
How many students in this family have already been enrolled for the selected school year?
Parent/Guardian Signature*

Clear
Coupon Code:
Enrollment:
Early Discount:
New Student Processing:
Card Processing:
Total:
If paying by check:

Please make checks payable to Family Christian Academy. Payments may be dropped off at the office or mailed to the address below.

Please Note: Enrollment is not complete until payment has been received.

Mailing Address:

Family Christian Academy

925 Industrial Dr.

Old Hickory, TN 37138
Credit/Debit Card (Online)Check (Mail or Office)

Credit/Debit Card Payment:

USDDescription